Perineal retractor

ABSTRACT

A perineal retractor for use in conducting diagnostic examinations and various surgical operations in and through the vagina to the cervix and corpus uteri. The retractor includes fiber optic lighting means mounted on the retractor blade for providing internal vaginal illumination, and a fenestrated basket may be removably positioned in the discharge trough to receive and collect the tissue specimens which are entrained in the fluids passing therealong.

United States Patent [191 Davis [4 1 Mar. 12, 1974 4] PERHNEAL RETRACTOR [76] Inventor: Rachel D. Davis, 111 E. Gordon St.,

Kinston, NC. 28501 [22] Filed: Dec. 4, 1972 [21] Appl. No.: 311,747

[52] US. Cl. 128/20, 128/2 F, 128/6 [51] Int. Cl. A6lb 17/02, A61b 1/30 [58] Field of Search 128/2 B, 3, 4, 6, 7, 17, 128/18, 20, 2 F, 341, 361

[56] References Cited UNITED STATES PATENTS 3,176,682 4/1965 Wexler 128/17 3,626,471 12/1971 Florin 128/6 X 2,666,428 1/1954 Glenner 128/20 FOREIGN PATENTS OR APPLICATIONS 208,607 4/1909 Germany 128/20 Primary Examiner-Lucie l-l. Laudenslager Attorney, Agent, or FirmParrott, Bell, Seltzer, Park & Gibson [5 7] ABSTRACT A perineal retractor for use in conducting diagnostic examinations and various surgical operations in and through the vagina to the cervix and corpus uteri. The retractor includes fiber optic lighting means mounted on the retractor blade for providing internal vaginal illumination, and a fenestrated basket may be removably positioned in the discharge trough to receive and collect the tissue specimens which are entrained in the I fluids passing therealong.

18 Claims, 5 Drawing Figures PERINEAL RETRACTOR.

The present invention relates to a perineal retractor useful in conducting diagnostic examinations in the vagina, and performing various surgical operations such as dilation and curettage, abortion, miscarriage and the like.

In performing examinations and operations of the described type, it is common to employ a perineal retractor which includes a relatively thin blade adapted to be inserted in the lower area of the vagina and which extends to the cervix and corpus uteri. The retractor also includes a downwardly extending integral body portion which is usually weighted by means of an enlarged bulbous portion. to achieve a self retaining characteristic, and which also includes a trough or channel to conduct the fluids resulting from the performance of the operation downwardly to a bucket or the like.

As a part of the above surgical procedures, it is common to collect various tissue specimens, such as endo metrial or cervical tissue, for pathological examination to thereby assist in diagnosis and treatment. Presently, such specimens are collected and removed with forceps, or with sterile gauze carried on forceps. This procedure is generally unsatisfactory however, in that it is time consuming and the specimens are often lost.

A further problem associated with the above procedures is the difficulty in obtaining adequate internal illumination. Conventionally, such illumination is provided by means of floor mounted goose neck lamps, or lamps held by either the physician or an attendant. The light emanating from these lamps is often partially blocked by other instruments or the physician, and thus adequate internal illumination is not achieved. Also, such lamps interfere with the physicians work field.

It is accordingly an object of the present invention to provide a perineal retractor of the described type which is designed to alleviate the above problems associated with present surgical procedures.

It is a more particular object of the present invention to provide a perineal retractor having provision for automatically collecting tissue samples which are entrained in the fluids associated with the operation.

It is another object of the present invention to provide a perineal retractor having provision for providing adequate illumination within the vaginal cavity.

These and other objects and advantages of the present invention are achieved in the embodiment illustrated herein by the provision of a perineal retractor which includes an arcuately curved retractor blade having generally parallel side edges and a rear edge portion, and a weighted body portion integrally connected to the retractor blade and extending downwardly from the rear edge portion. The body portion includes a trough extending from the rear edge portion downwardly, and a fenestrated basket is adapted to be removably positioned within the trough such that the fluids wash through the basket and the entrained specimens are collected therein. Also, fiber optic lighting means are mounted along the retractor blade for providing internal vaginal illumination.

Some of the objects of the invention having been stated, other objects will appear as the description proceeds, when taken in connection with the accompanying drawings, in which FIG. 1 is a perspective view of a perineal retractor embodying the features of the present invention;

FIG. 2 is a perspective view of the opposite side of the perineal retractor shown in FIG. 1;

FIG. 3 is a fragmentary rear elevational view of the upper portion of the perineal retractor shown in FIGS. 1 and 2;

FIG. 4 is a sectional side view taken substantially along the line 44 in FIG. 3;

FIG. 5 is a sectional top plan view taken substantially along the line 5-5 of FIG. 3.

Referring more specifically to the drawings, a perineal retractor embodying the features of the present invention is illustrated generally at 10. The retractor includes an arcuately curved retractor blade which is adapted to be inserted in the lower area of the vagina, and which defines a forward edge 14, generally parallel edges 16 and 17 extending along the length thereof, a rear edge portion 18, and a somewhat concave upper surface 19. The side edges 16 and 17 flare somewhat outwardly and upwardly adjacent the rear edge portion to define lateral side flanges 21, 22 which extend generally transversely to the plane of the blade 12 and are curved slightly posteriorly, i.e., toward the physician, to define a relatively deep posterior curve which generally conforms to the natural anatomical curve of the perineum. The retractor 10 further includes a body portion 24 which is integrally connected to the blade 12 and extends downwardly from the rear edge portion 18. As best seen in FIG. 4, the blade 12 extends outwardly from the body portion 24 at an acute angle of about 60 to thereby provide a self retaining characteristic for the retractor as hereinafter further described.

The upper end of the body portion 24 includes a generally planar surface 25 forming an interconnection between the rear edge portion 18 of the blade and the flanges 21 and 22. Generally V-shaped lips 26 and 27 are positioned along the lower edge of the surface 25 to define the upper portion of a channel or trough 30 which is generally U-shaped in cross section and extends along the length of the body portion. A bulbous enlargement 32 is formed along the lower portion of the body portion to increase the weight of the retractor.

Thus the weight of bulbous portion 32 and the above described inclination of the blade 12 with respect to the body portion serves to provide a self retaining characteristic such that the blade 12 may be maintained in the desired position in the vagina without external support.

A fenestrated basket 34 is provided for use in association with the retractor, and the illustrated embodiment comprises a generally cylindrical side wall 36, a flat bottom wall 38, and an open top. The basket 34 may be fabricated from metal wire screen such that the basket is somewhat flexible for the reasons hereinafter set forth. Also, the use of a suitable wire screen, such as stainless steel, will permit the basket to be used and sterilized repeatedly. Alternatively, the basket 34 may be constructed from plastic screen such that the basket is of low cost and therefore may be economically discarded after a single use.

The basket 34 is adapted to be received with the trough 30 at a basket receiving station indicated generally at 40. The basket receiving station includes a generally cylindrical wall 42 forming an arc of a circle in cross-sectional outline. As seen in FIG. 5, the arc of the wall 42 extends somewhat more than and generally conforms to the cross-sectional outline of the basket side wall 36. The basket receiving station 40 further includes an arcuate shoulder or detent 44 defining the lower end of the station, and a second arcuate shoulder or detent 46 defining the upper end thereof. By this arrangement the basket 34 may be received within the station 40 with the bottom wall 38 of the basket resting upon the detent 44, and the wall 42 of the station 40 surrounding somewhat more than half of the side wall 36 of the basket.

To insert the basket 3 3 within the station 40, the basket is translated horizontally in the manner shown in dashed lines in FIG. ll. Since the basket is somewhat flexible, the walls 36 will be slightly compressed upon insertion, and will expand to its original configuration upon being fully inserted into the station. Thus the basket is retained within the station by the encompassing wall 42 and the lower detent The upper detent 46 serves to direct the fluids flowing downwardly along the trough 30 into the open end of the basket.

To withdraw the basket 34 from the station 40, the above process is merely reversed. Thus the basket may be drawn outwardly from the station with the side wall 36 collapsing slightly to permit passage past the encompassing wall 42.

As a further aspect of the present invention, fiber optic lighting means is mounted along the blade 12 for providing internal illumination. More particularly, the fiber optic lighting means includes a pair of tubular members 50, 51 carried on the upper concave surface 19 of the blade l2 such that one of the tubular members extends along each of the side edges 16 and 17. The tubular members may be joined to the blade by any conventional technique, such as soldering, and the junctures may be filleted to provide a smoothly rounded outer surface. Each of the tubular members may be fabricated from a suitable metallic material, and includes an open forward end 52, 53 respectively, the ends being positioned immediately adjacent the forward edge 14 of the blade 12. A fiber optic bundle (not specifically shown) is carried within each of the tubular members, and each of the tubular members includes a rear end mounting a coupler 55 for operatively connecting each of the fiber optic bundles to a flexible light conducting tube 56, the tube 56 .in turn being operatively connected to an external light source illustrated schematically at 58. The rear end of the tubular members and thus the couplers 55 are preferably spaced at least about eight inches from the flanges 21, 22 to prevent the non-sterilized tubes 56 from contaminating the sterile work area. The specific structure of the fiber optic bundles and light source 58 are conventional, and well known to those skilled in the art. In addition, one or both of the forward ends 52, 53 the tubular members 50, 51 and associated fiber optic bundles may be beveled slightly (note FIG. 4) so that the light emanating from the bundles will be refracted somewhat upwardly from the blade 12 so as to provide greater light distribution.

As will be apparent, the use of the above described fiber optic lighting means provides several significant advantages over total reliance on externally mounted lamps. For example, the fiber optic lighting means provides a great amount of illumination directly within the vaginal cavity, the light source remains cool, and it is not susceptible to breakage. Also, the hands of the physician remain free to perform the necessary surgical operations, and there is no interference with his work field as is the case with the large external lamps. Further, the tubular members 50, 51 and the remaining portions of the retractor 10 may be constructed from metal which is suitably plated, for example with chromium, to facilitate sterilization.

In the drawings and specification, there has been set forth a preferred embodiment of the invention, and although specific terms are employed, they are used in a generic and descriptive sense only and not for purposes of limitation.

That which is claimed is:

l. A lighted perineal retractor for use in conducting diagnostic examinations and various surgical operations in the vagina, and which is adapted to provide internal vaginal illumination to thereby substantially reduce the need for external hand held lamps and the like, said retractor comprising an arcuately curved retractor blade adapted to be inserted in the lower area of the vagina and having generally parallel side edges extending along the length thereof, a forward edge, and a rear edge portion, I

a weighted body portion integrally connected to said retractor blade and extending downwardly from the rear edge portion thereof, and.

fiber optic lighting means mounted to extend a substantial distance along at least one side edge of said retractor blade for providing internal vaginal illumination.

2. The perineal retractor as defined in claim 1 wherein said fiber optic lighting means includes first lighting means mounted to extend a substantial distance along one side edge, and second lighting means mounted to extend a substantial distance along the other side edge.

3. The perineal retractor as defined in claim I wherein said fiber optic lighting means includes a tubular member extending along each side edge of said retractor blade and defining a light emitting forward end, a fiber optic bundle carried within each of said tubular members, and means for operatively connecting an external light source to each of said fiber opticbundles.

4. The perineal retractor as defined in claim 3 wherein the forward end of at least one of said tubular members and the associated fiber optic bundle is beveled such that the light emanating therefrom is refracted upwardly from said blade.

5. The perineal retractor as defined in claim 3 wherein said retractor blade further defines a generally concave upper surface, said tubular members are fixedly mounted to said upper surface of said blade immediately adjacent the side edges, and said forward ends of said tubular members are positioned adjacent said forward edge of said retractor blade.

6. The perineal retractor as defined in claim 3 wherein said means for operatively connecting an external light source to each of said fiber optic bundles includes a coupler carried by each of said tubular members adjacent said rear edge portion of said blade.

7. The perineal retractor as defined in claim 3 wherein said retractor blade, said body portion, and each of said tubular members are constructed from chronium plated metal to facilitate sterilization.

8. The perineal retractor as defined in claim 1 wherein said retractor blade extends outwardly from said body portion at an acute angle of about 60 to provide a self retaining characteristic.

9. A perineal retractor for use in conducting diagnostic examinations and various surgical operations in and through the vagina and having provision for collecting tissue specimens for pathological examination and the I like and comprising an arcuately curved retractor blade adapted to be inserted in the lower area of the vagina and having a rear edge portion,

a body portion integrally connected to said retractor blade and extending downwardly from the rear edge portion thereof and including trough means extending from the rear edge portion along the length of said body portion for conveying fluids and entrained tissue specimens therealong, and

fenestrated basket means adapted to be removably positioned within said trough means such that the fluids and entrained specimens being conveyed along said trough means pass into said basket means and the fluids pass therethrough while the entrained specimens are collected therein.

10. The perineal retractor as defined in claim 9 wherein said trough means comprises a trough of generally U-shaped cross-sectional configuration, and said basket means comprises a basket including a side wall having a cross sectional configuration generally conforming to that of said trough, an open top, and a bottom wall.

11. The perineal retractor as defined in claim 10 further comprising means for releasably retaining said basket within said trough at a predetermined location along the length thereof.

12. The perineal retractor as defined in claim 11 wherein said means for releasably retaining said basket within said trough comprises a detent formed within said trough and adapted to supportingly engage the bottom wall of said basket.

13. The perineal retractor as defined in claim 9 wherein said basket means comprises a somewhat flexible basket including a generally cylindrical side wall, a bottom wall, and an open top, and

said trough means includes a basket receiving station adapted to receive said basket therewithin, said basket receiving station including a generally cylindrical wall forming an arc of a circle in crosssectional outline which extends somewhat more than 180 and which generally conforms to the cross-sectional outline of said basket side wall, and a detent positioned at the lower end of said basket receiving station, whereby the basket may be received within said basket receiving station with the bottom wall of said basket restingupon said detent and the wall of the basket receiving station surrounding somewhat more than half of the side wall 5 of said basket to thereby releasably retain the basket therein.

14. The perineal retractor as defined in claim 13 wherein said basket receiving station further includes upper detent means for directing fluids flowing downwardly along said trough means into said open top of said basket.

15. The perineal retractor as defined in claim l3 wherein said basket is fabricated from metal wire screen such that the basket may be repeatedly used and sterilized.

16. The perineal retractor as defined in claim 13 wherein said basket is fabricated from plastic screen such that the basket may be economically discarded after a single use.

17. A lighted, self retaining perineal retractor for use in conducting various surgical operations in and through the vagina and which is adapted to provide internal vaginal illumination and which has provision for collecting tissue specimens for pathological examination and the like, and comprising an arcuately curved retractor blade adapted to be inserted in the lower area of the vagina and having generally parallel side edges extending along the length thereof, and a rear edge portion,

a weighted body portion integrally connected to said retractor blade and extending downwardly from the rear edge portion thereof, said body portion including a bulbous enlargement for increasing the weight thereof and trough means extending from the rear edge portion of said retractor blade and along the length of said body portion for conveying fluids and entrained specimens therealong,

a fenestrated basket adapted to be removably positioned within said trough means such that the fluids and entrained specimens being conveyed along said trough means pass into said basket and the fluids pass therethrough while the entrained specimens are collected therein, and

fiber optic lighting means mounted along said retractor blade for providing internal vaginal illumination.

18. The perineal retractor as defined in claim 17 further comprising means for releasably retaining said bas- 50 ket in operative position within trough means. 

1. A lighted perineal retractor for use in conducting diagnostic examinations and various surgical operations in the vagina, and which is adapted to proVide internal vaginal illumination to thereby substantially reduce the need for external hand held lamps and the like, said retractor comprising an arcuately curved retractor blade adapted to be inserted in the lower area of the vagina and having generally parallel side edges extending along the length thereof, a forward edge, and a rear edge portion, a weighted body portion integrally connected to said retractor blade and extending downwardly from the rear edge portion thereof, and fiber optic lighting means mounted to extend a substantial distance along at least one side edge of said retractor blade for providing internal vaginal illumination.
 2. The perineal retractor as defined in claim 1 wherein said fiber optic lighting means includes first lighting means mounted to extend a substantial distance along one side edge, and second lighting means mounted to extend a substantial distance along the other side edge.
 3. The perineal retractor as defined in claim 1 wherein said fiber optic lighting means includes a tubular member extending along each side edge of said retractor blade and defining a light emitting forward end, a fiber optic bundle carried within each of said tubular members, and means for operatively connecting an external light source to each of said fiber optic bundles.
 4. The perineal retractor as defined in claim 3 wherein the forward end of at least one of said tubular members and the associated fiber optic bundle is beveled such that the light emanating therefrom is refracted upwardly from said blade.
 5. The perineal retractor as defined in claim 3 wherein said retractor blade further defines a generally concave upper surface, said tubular members are fixedly mounted to said upper surface of said blade immediately adjacent the side edges, and said forward ends of said tubular members are positioned adjacent said forward edge of said retractor blade.
 6. The perineal retractor as defined in claim 3 wherein said means for operatively connecting an external light source to each of said fiber optic bundles includes a coupler carried by each of said tubular members adjacent said rear edge portion of said blade.
 7. The perineal retractor as defined in claim 3 wherein said retractor blade, said body portion, and each of said tubular members are constructed from chronium plated metal to facilitate sterilization.
 8. The perineal retractor as defined in claim 1 wherein said retractor blade extends outwardly from said body portion at an acute angle of about 60* to provide a self retaining characteristic.
 9. A perineal retractor for use in conducting diagnostic examinations and various surgical operations in and through the vagina and having provision for collecting tissue specimens for pathological examination and the like and comprising an arcuately curved retractor blade adapted to be inserted in the lower area of the vagina and having a rear edge portion, a body portion integrally connected to said retractor blade and extending downwardly from the rear edge portion thereof and including trough means extending from the rear edge portion along the length of said body portion for conveying fluids and entrained tissue specimens therealong, and fenestrated basket means adapted to be removably positioned within said trough means such that the fluids and entrained specimens being conveyed along said trough means pass into said basket means and the fluids pass therethrough while the entrained specimens are collected therein.
 10. The perineal retractor as defined in claim 9 wherein said trough means comprises a trough of generally U-shaped cross-sectional configuration, and said basket means comprises a basket including a side wall having a cross sectional configuration generally conforming to that of said trough, an open top, and a bottom wall.
 11. The perineal retractor as defined in claim 10 further comprising means for releasably retaining said basket within said trough at a predetermiNed location along the length thereof.
 12. The perineal retractor as defined in claim 11 wherein said means for releasably retaining said basket within said trough comprises a detent formed within said trough and adapted to supportingly engage the bottom wall of said basket.
 13. The perineal retractor as defined in claim 9 wherein said basket means comprises a somewhat flexible basket including a generally cylindrical side wall, a bottom wall, and an open top, and said trough means includes a basket receiving station adapted to receive said basket therewithin, said basket receiving station including a generally cylindrical wall forming an arc of a circle in cross-sectional outline which extends somewhat more than 180* and which generally conforms to the cross-sectional outline of said basket side wall, and a detent positioned at the lower end of said basket receiving station, whereby the basket may be received within said basket receiving station with the bottom wall of said basket resting upon said detent and the wall of the basket receiving station surrounding somewhat more than half of the side wall of said basket to thereby releasably retain the basket therein.
 14. The perineal retractor as defined in claim 13 wherein said basket receiving station further includes upper detent means for directing fluids flowing downwardly along said trough means into said open top of said basket.
 15. The perineal retractor as defined in claim 13 wherein said basket is fabricated from metal wire screen such that the basket may be repeatedly used and sterilized.
 16. The perineal retractor as defined in claim 13 wherein said basket is fabricated from plastic screen such that the basket may be economically discarded after a single use.
 17. A lighted, self retaining perineal retractor for use in conducting various surgical operations in and through the vagina and which is adapted to provide internal vaginal illumination and which has provision for collecting tissue specimens for pathological examination and the like, and comprising an arcuately curved retractor blade adapted to be inserted in the lower area of the vagina and having generally parallel side edges extending along the length thereof, and a rear edge portion, a weighted body portion integrally connected to said retractor blade and extending downwardly from the rear edge portion thereof, said body portion including a bulbous enlargement for increasing the weight thereof and trough means extending from the rear edge portion of said retractor blade and along the length of said body portion for conveying fluids and entrained specimens therealong, a fenestrated basket adapted to be removably positioned within said trough means such that the fluids and entrained specimens being conveyed along said trough means pass into said basket and the fluids pass therethrough while the entrained specimens are collected therein, and fiber optic lighting means mounted along said retractor blade for providing internal vaginal illumination.
 18. The perineal retractor as defined in claim 17 further comprising means for releasably retaining said basket in operative position within trough means. 